levetiracetam and Astrocytoma

Topics: Anticonvulsants; Astrocytoma; Brain Neoplasms; Epilepsy, Generalized; Female; Humans; Italy; Levetiracetam; Middle Aged; Rhabdomyolysis

Patients with grade IV astrocytoma or glioblastoma multiforme (GBM) have a median survival of <12 months, increased to 14.6 months by maximal safe resection with radiation and temozolamide. In the absence of chemotherapy, radiotherapy or chemoradiotherapy, spontaneous regression of GBM or regression while only being on dexamethasone (DEX) and levetiracetam (LEV) have seldom been reported. Here, we present a case of a patient who had significant regression of the GBM with DEX and LEV alone. In this study, we hypothesise a plausible antineoplastic role of DEX and or LEV in GBM and highlight molecular, preclinical and clinical studies supporting this role.

Topics: Antineoplastic Combined Chemotherapy Protocols; Astrocytoma; Brain Neoplasms; Cognition Disorders; Dacarbazine; Dexamethasone; Glioblastoma; Humans; Levetiracetam; Magnetic Resonance Imaging; Male; Middle Aged; Neoplasm Regression, Spontaneous; Neoplasms, Second Primary; Piracetam; Temozolomide

Transcranial electrical motor-evoked potential (tceMEP) monitoring is used in complex intracranial and spinal surgeries to detect and prevent neurological injury. We present a case of transient, reproducible loss of tceMEPs after an infusion of levetiracetam during craniotomy and tumor resection in a child. Cessation of the infusion resulted in restoration of baseline tceMEPs. When the infusion was resumed at the end of the procedure, a similar decrease in tceMEPs was seen as before, after the infusion was stopped. The surgery and postoperative course proceeded without incident, and the patient experienced a full recovery.

Topics: Anticonvulsants; Astrocytoma; Brain Neoplasms; Child; Craniotomy; Evoked Potentials, Motor; Evoked Potentials, Somatosensory; Female; Humans; Infusions, Intravenous; Levetiracetam; Monitoring, Intraoperative; Piracetam

A 45-year-old man with a new diagnosis of low grade glioma was started on an escalating dose of levetiracetam (Lev) for seizure management. He gradually developed intractable nausea/vomiting and a high creatinine concentration due to acute renal failure which was attributed to Lev-induced interstitial nephritis. The medication was changed and his renal function rapidly improved to his baseline.

Topics: Acute Kidney Injury; Anticonvulsants; Astrocytoma; Brain Neoplasms; Humans; Levetiracetam; Male; Middle Aged; Nephritis, Interstitial; Piracetam; Seizures

Topics: Aged; Amygdala; Anticonvulsants; Astrocytoma; Brain Neoplasms; Electroencephalography; Hippocampus; Humans; Levetiracetam; Magnetic Resonance Imaging; Male; Piloerection; Piracetam; Seizures; Temporal Lobe; Valproic Acid